小剂量氯胺酮对预防剖宫产产后抑郁疗效的meta分析  

Meta Analysis of the Effect of Low-Dose Ketamine on the Prevention of Postpartum Depression in Cesarean Section Women

作　　者：刘旭 韩艳阳 张永强[1] LIU Xu;HAN Yanyang;ZHANG Yongqiang(Department of Anesthesia.the First Affiliated Hospital of Xinxiang Medical College,Xinxiang 453100,China;Pain Department,the First Affiliated Hospital of Xinxiang Medical College,Xinxiang 453100,China)

机构地区：[1]新乡医学院第一附属医院麻醉科,河南新乡453100 [2]新乡医学院第一附属医院疼痛科,河南新乡453100

出　　处：《河南医学研究》2022年第22期4062-4067,共6页Henan Medical Research

基　　金：河南省卫健委医学教育研究项目(Wjlx2021358)。

摘　　要：目的系统评价小剂量氯胺酮对预防剖宫产产妇产后抑郁(PPD)的疗效。方法系统检索Pubmed、Web of Science、Enbase、万方数据库、中国知网、中华医学会数据库,检索时间从建库截至2021年11月。使用Stata 12.0和Revman 5.4进行统计分析。结果最终纳入9项研究,共计3053例患者,根据是否使用氯胺酮将患者分为氯胺酮组(1187例)和对照组(1866例)。meta分析结果显示氯胺酮组术后短期(≤1周)PPD发生率低于对照组(P<0.05);术后长期(>1周)PPD发生率低于对照组(P<0.05);氯胺酮组用药15 min内恶心呕吐、头晕的发生率高于对照组(P<0.05),极少数氯胺酮组患者出现幻觉、头痛等不良反应,且在出手术室之前均能得到有效缓解。结论剖宫产术中或术后使用小剂量的氯胺酮可以降低剖宫产术后PPD的发生率,但增加了术中不良反应发生风险。Objective To evaluate the efficacy of low-dose ketamine in preventing postpartum depression(PPD)in cesarean section women.Methods Pubmed,Web of Science,Enbase,Wanfang database,CNKI,and the database of the Chinese Medical Association were systematically searched.The retrieval time was from the establishment of the database to November 2021.Stata 12.0 and Revman 5.4 were used for statistical analysis.Results Totally 3053 patients were included in 9 studies,and were divided into ketamine group(1187 cases)and control group(1866 cases)according to whether ketamine was used.Meta analysis showed that the incidence of PPD in ketamine group was lower than that in control group in the short term(≤1 week)(P<0.05),and the incidence of PPD in the long term(>1 week)after operation was lower than that in the control group(P<0.05).The incidence of nausea,vomiting and dizziness in the ketamine group was higher than that in the control group within 15 minutes(P<0.05).A few patients in the ketamine group had hallucinations,headache and other adverse reactions,which could be effectively alleviated before leaving the operating room.Conclusion The use of low-dose ketamine during or after cesarean section can reduce the incidence of PPD after cesarean section,but increase the risk of adverse reactions during operation.

关 键 词：小剂量氯胺酮 产后抑郁 不良反应 META分析 

分 类 号：R749.29[医药卫生—神经病学与精神病学]